中国普外基础与临床杂志

中国普外基础与临床杂志

一种新型手工肠吻合方法应用于胃癌 Roux-en-Y 吻合中的有效性及安全性分析

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目的 比较新型手工缝合吻合和器械吻合在胃癌 Roux-en-Y 吻合中的效果。 方法 回顾性收集 2014 年 1 月至 2017 年 6 月期间在笔者所在诊疗组接受根治性远端或全胃切除术的 200 例胃癌患者,根据吻合方式分为观察组 100 例(新型手工缝合吻合)和对照组 100 例(器械吻合),比较 2 组患者的吻合时间、吻合费用、吻合相关并发症发生情况(包括吻合口出血、吻合口漏和和吻合口狭窄)和住院时间。 结果 观察组的吻合费用低于对照组组[(194.1±13.5)元比(5 270.3±852.7)元,P<0.001],但 2 组者的吻合时间[(8.34±0.65)min 比(8.29±0.61)min,P=0.540]、吻合口出血发生率[0(0/100)比 3%(3/100),P=0.246]、吻合口漏发生率[0(0/100)比 1%(1/100),P=1.000]、吻合口狭窄发生率[0(0/100)比 2%(2/100),P=0.497]和住院时间[(18.8±7.4)d 比(19.2±6.2)d,P=0.175]比较差异无统计学意义。 结论 该新型手工缝合吻合技术安全有效,简单易学,省钱省时,值得推广。

Objective To compare the effectiveness between a new hand-sewn intestinal anastomosis and stapled anastomosis during Roux-en-Y anastomosis of gastric cancer. Methods Retrospectively, we collected 200 gastric cancer patients whom underwent radical distal or total gastrectomy from January 2014 to June 2017 in our hospital, and divided them into observation group (new hand-sewn anastomosis, n=100) and control group (stapled anastomosis, n=100) according to the type of anastomosis. The time and cost taken to perform the anastomosis, the incidence of postoperative complications (including anastomotic leakage, bleeding, and stenosis), and length of hospital stay were compared. Results The cost of anastomosis in the observation group was significantly lower than that of the control group [(194.1±13.5) RMB vs (5270.3±852.7) RMB, P<0.001], and the time taken to perform was just slightly longer in the observation group [(8.34 ± 0.65) minvs (8.29±0.61 ) min, P=0.540], additionally the incidences between the observation group and the control group, in regards to anastomotic bleeding[0 (0/100) vs 3% (3/100), P=0.246], leakage[0 (0/100) vs 1% (1/100), P=1.000], stenosis [0 (0/100) vs 2% (2/100), P=0.497], and length of hospital stay [(18.8±7.4) d vs (19.2±6.2) d, P=0.175], showed no significant difference between the 2 groups. Conclusions The new hand-sewn anastomosis technology is safe and effective, easy to learn, save money and time, which is worth promoting.

关键词: 新型手工缝合吻合; 器械吻合; Roux-en-Y 吻合; 胃癌; 效果

Key words: hand-sewn intestinal anastomosis; stapled anastomosis; Roux-en-Y anastomosis; gastric cancer; effect

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